Jennifer is a 29-year-old administrative assistant married to Antonio, an Italian engineer, whom Jennifer met four years earlier while on a business trip for her marketing company. The couple now lives in Nebraska, where Antonio works for the county's transportation department and Jennifer commutes an hour each way to her marketing office. They have been trying to start a family for over a year. Eight months ago, Jennifer miscarried in her second month of pregnancy. Antonio's parents love Jennifer and often ask her if she is expecting again, hoping to encourage her to focus on her next baby. Jennifer's mother passed away two years ago and her father's health is rapidly deteriorating. Jennifer faces the probability of placing her father in a skilled nursing care facility within the next few months, against his wishes.

At work, Jennifer runs a tight ship. She is organized and prepares lists to assure that everything is done according to schedule. Everyone counts on Jennifer and she takes pride in never letting people down.

Jennifer has visited her physician numerous times in the last six months, complaining of headaches, backaches, and indigestion. Jennifer insists that she is happy and is not feeling stressed, yet she finds herself making more mistakes at work, unable to keep up with housework, and feeling tired and overwhelmed; she has begun to question her effectiveness as an employee, wife, daughter, and potential mother. Her pains seem to be increasing, but her doctor cannot find a physical cause for her discomfort.

Case Study #2

Michael is a 40-year-old airline pilot who has recently begun to experience chest pains. The chest pains began when Michael signed his final divorce papers, ending his 15-year marriage. He fought for joint custody of his two children, ages 12 and 10, but although he wants to be with them more frequently, he only sees them every two weeks. This schedule is, in great part, a result of his employer's announcement that budget constraints would result in layoffs. Michael worries that without his job he will be unable to support his children and lose the new townhouse that he purchased. Michael's chest pains are becoming more frequent and he fears that he may be dying.

Question and answer
1. What are the causes of stress in Michael’s or Jennifer’s life? How is stress affecting Michael’s or Jennifer’s health?.

The causes of stress in Michael life are the divorce, the joint custody and a possibility that he might lose his job. In essence, Michael is going through some major changes in his life with not much time for adaptation and with no time for recovery. Although, these changes are negatives, they contributed an enormous amount of stress that necessitate adjustment.
Stress has negatively affected Michael’s health as a result of his ability to deal with life changes and impairs his performance. Michael started experiencing chest pains as well as panic attacks; fearing that he is going to die. Pain is the body’s warning signal, therefore, Michael should consult a cardiologist to rule out medical causes for the chest pain. Once the cardiologist determined that stress as well as multiple life changes are the cause of Michael’s chest pain; he will be imperative for him to learn healthy ways to reduce his stress levels and increase his ability to cope under stress.

The causes of stress in Jennifer’s life are very complexed. she is having frustration of commuting, she is also dealing with a miscarriage and Antonio’s parents pressuring her to have another pregnancy; her mother had passed away about two years ago, and now her father is in a deteriorating stage where she is has to make decision to send him to a skilled nursing care facility since she will not be able to take care of him. Jennifer is experiencing multiple approach-avoidance conflict. All those issues presented in front of her have their negative and positive side. From the information read, Jennifer is not being active in dealing with her stress; she is paralyzed with indecision.

Jennifer’s health has been negatively impacted by stress. In the last six months, Jennifer visited her physician and has been complaining numerous times of headaches, backaches, and indigestion. Stress is also affecting her performance at work; she is not trying to overcome her stress and finding solutions because she is in denial. A healthy way to resolve her conflict is to know that she has a choice and accept her locus of control.